This is a "REFILL" episode recorded in September 2025. At the time of recording, Dutch Rojas was a healthcare entrepreneur, founder of multiple direct contracting companies, and board member of Physician Led Healthcare for America, with a growing following on social media advocating for market-based healthcare solutions.Joe Grogan sits down with Dutch Rojas, healthcare entrepreneur and social media advocate, to discuss his journey from accounting to building direct contracting companies that revolutionize employer healthcare. Rojas explains how direct contracting allows employers to negotiate directly with physicians, bypassing insurance middlemen. The conversation covers his experience building ambulatory surgery centers, certificate of need laws, self-funded employer plans, and his critique of not-for-profit health systems. Rojas argues that academic medical centers masquerade as not-for-profit organizations while receiving seventy-four subsidies annually from taxpayers, acquiring massive real estate holdings, and avoiding property and federal taxes. He advocates for policy changes on not-for-profit tax status and site-neutral payments, arguing these represent unfair advantages that harm independent physicians and patients.Key Timestamps0:18 Joe introduces Dutch Rojas and asks who is Dutch Rojas1:32 Dutch's background, career path, and journey to social media2:22 Physician-led Healthcare for America and PHA board4:32 Starting in accounting, real estate investment trust, and ambulatory surgery centers5:14 150 ambulatory surgery center deals and certificate of need experience7:34 Building a practice in Scottsdale and expanding to 16 states9:30 First direct contracting company in 2009 and how direct contracting works12:45 Self-funded employer plans and 106 million Americans not covered by insurance15:22 Deals with banks and large employers in New York City18:09 The difference between clinical medicine and business in medicine22:15 Building insurance products on top of physician-led care28:30 How direct contracting saves employers money32:18 The three companies Dutch has started and sold38:45 Healthcare as a percentage of GDP and rising costs42:10 Regulatory hurdles and state-level barriers46:54 Not-for-profit tax status and academic health systems48:07 How health systems receive subsidies but claim non-profit status48:22 Academic medical centers owning four to five percent of city real estate49:21 Site-neutral payments and payment disparities between settings50:28 Dutch's social media reach and audience impactKey TopicsDirect contracting, healthcare economics, physician-led care, ambulatory surgery centers, certificate of need, self-funded employer plans, not-for-profit health systems, tax exemptions, site-neutral payments, healthcare regulation, real estate holdings, academic medical centers, employer negotiations, insurance reform, market-based healthcareAbout the Guest (at time of recording, September 2025)Dutch Rojas is a healthcare entrepreneur with over 25 years of experience in healthcare economics and business. He started in accounting and real estate investment, then moved into healthcare, developing over 150 ambulatory surgery centers. Rojas founded multiple direct contracting companies that help employers negotiate directly with physicians, bypassing traditional insurance intermediaries. He serves on the board of Physician Led Healthcare for America. He has built a significant social media following on X (formerly Twitter), sharing his analysis of healthcare policy and economics. Rojas is the author of the Rojas Report and hosts a YouTube channel and Substack focused on healthcare reform and market-based solutions.Podcast: DC EKG with Joe GroganHost: Joe GroganGuest: Dutch RojasSponsor: Survivors for SolutionsExecutive Producer: John CZ Czwartacki, DC EKG Podcast

In this "Refill" episode, Joe Grogan sits down with Dr. Brian Miller to discuss the "Valley of Death" - the gap between FDA approval and CMS coverage - and how regulatory reform can accelerate medical innovation. Miller explains how FDA product review can be made more efficient through automation and algorithmic analysis of routine tasks, allowing highly trained reviewers to focus on clinical interpretation rather than data processing. The conversation covers clinical trial reform, device review modernization, third-party review programs, and CMS coverage decision processes. Miller argues that these are operational challenges that can be fixed with executive leadership, and that transforming FDA and CMS procedures is critical to bringing new medicines and devices to patients faster.Key Timestamps1:23  Brian Miller background and AEI role2:47  The Valley of Death - gap between FDA approval and CMS coverage5:06  Making FDA and CMS review processes more synergistic7:43  Example of hypertension drug review and routine tasks8:26  Data overload in FDA review process10:40  Supplemental applications and unnecessary information12:01  FDA reviewer burnout and middle management proliferation15:30  Automating routine tasks at FDA17:33  Clinical trial reform discussion and regulatory risk20:03  Practical approach for new FDA commissioner and DOGE21:22  Operational changes needed at FDA22:48  Tobacco regulation at FDA and resource allocation25:10  Device world getting short shrift in FDA priorities27:33  Third-party 510k review program and third-party organizations29:09  COVID diagnostic tests and pandemic review process30:51  Reforming CDRH through third-party reviews31:36  70-year comparison of heart attack treatment advances32:46  CMS coverage decisions and Coverage with Evidence Development36:02  Medicare Administrative Contractors (MACs) and local coverage decisions38:12  Practical market-based approach to MAC appeals39:54  National vs local coverage decisions and reasonable and necessary standard42:28  Defining reasonable and necessary through algorithms and guidanceKey TopicsFDA regulatory reform, Valley of Death, clinical trial reform, FDA product review automation, CMS coverage decisions, Medicare Administrative Contractors, third-party device review, drug development costs, medical innovation, device regulation, regulatory science, operational efficiencyAbout the Guest (at time of recording, March 2025)Dr. Brian Miller is a physician and non-resident fellow at the American Enterprise Institute (AEI) focusing on FDA regulatory policy and Medicare payment policy. He practices medicine at Johns Hopkins Hospital and serves as an associate professor of medicine and business at Johns Hopkins University. His research and policy work emphasize making regulatory systems more efficient to accelerate the development and approval of innovative medicines and medical devices.Podcast: DC EKG with Joe GroganHost: Joe GroganGuest: Dr. Brian MillerSponsor: Survivors for SolutionsExecutive Producer: John CZ Czwartacki, DC EKG Podcast

Joe Grogan sits down with Peter Pitt, FDA veteran and expert on healthcare regulation, to discuss FDA advisory committees, the Make America Healthy Again initiative, and critical gaps in pharmaceutical labeling. Pitt addresses why obesity-related drug dosing information is missing from labels, the importance of vaccine safety, food regulation reform, and strategies for lowering drug prices through generic drug reviews and supply chain diversification. He also discusses the need for FDA and CMS to work together and warns against mission creep at CMS.Key Timestamps0:44 Background: East Coast native, McGill University, from New York City1:07 How he got a professorship at University of Paris School of Medicine2:35 Mark McClellan connection and FDA career start5:19 Conflicts of interest versus interests in FDA advisory committees7:07 Why people need to be dismissed from advisory committees9:13 Three basic reasons FDA holds advisory committee meetings11:08 Why Canada keeps advisory committees secret versus FDA transparency14:08 Advisory committees for CYA, new science, and lack of consensus19:44 Op-ed on vaccines and nutrition under Make America Healthy Again22:44 Cancer drug dosing for obese patients and missing label information27:15 Learning about drug dosing outside of clinical trials30:42 Food regulation and FDA's second-class treatment of food safety32:02 MAHA moment and removing red food dyes from food supply34:00 Dietary supplements regulation under DSHEA35:21 Nutrition labeling updates and soda bottle serving sizes38:21 PDUFA reauthorization and user fees40:32 User fees about predictability not speed42:54 CMS mission creep and encroaching on FDA authorityKey TopicsFDA advisory committees, transparency, vaccine safety, Make America Healthy Again, pharmaceutical labeling, obesity and drug dosing, food regulation, dietary supplements, generic drug review, PDUFA reauthorization, user fees, CMS mission creep, drug pricingAbout the Guest (at time of recording, May 2025)Peter Pitt is President and Co-Founder of the Center for Medicine in the Public Interest and a visiting professor at the University of Paris School of Medicine. He is a former associate commissioner at the FDA where he oversaw advisory committees and served as a senior policy and communications advisor. Pitt is a native of New York City, a McGill University graduate, and speaks fluent French.Podcast: DC EKG with Joe GroganHost: Joe GroganGuest: Peter PittSponsor: Survivors for SolutionsExecutive Producer: John CZ Czwartacki, DC EKG Podcast

Podcast TitleDC EKG with Joe Grogan: A Healthcare Policy PodcastThis is a REFILL of Episode124 - (Original air date: January 27, 2026)Episode Title - Ryan Long on the ACA Subsidy Fight, Phantom Enrollees, and Reforming 340BEpisode Description - Joe Grogan is joined by Ryan Long of Paragon Health Institute and the University of Southern California to break down two fights shaping health policy right now: a California wealth tax pitch framed as a health care fix, and the battle over extending enhanced Affordable Care Act subsidies.They unpack how enhanced subsidies changed who qualifies, why zero-premium plans opened the door to broker-driven enrollment and fraud, and why the medical loss ratio creates perverse incentives that can push premiums higher. They also explain how silver loading and cost-sharing reduction policy distort the exchange market, and what reforms could lower costs without writing a blank check.The episode closes with Ryan's latest work on the 340B program, including why drug arbitrage rewards hospitals with a stronger commercial mix and can fuel consolidation, and why direct, targeted assistance could better support hospitals that truly serve low-income and rural patients.Chapters and Timestamps00:01 Intro00:23 Welcome, and what is on the agenda01:25 California wealth tax and structural deficits11:20 Enhanced ACA subsidies and the shutdown fight16:54 Income caps, zero premium plans, and phantom enrollees21:50 Fraud, Medicaid exposure, and public trust30:39 Medical loss ratio incentives and ACA market fixes38:41 340B: how arbitrage works and why it drives consolidation44:51 What reform could look like47:20 ClosingSEO Keywords | Affordable Care Act, ACA subsidies, enhanced subsidies, premium tax credits, exchange plans, zero premium plans, phantom enrollees, medical loss ratio, cost sharing reduction, silver loading, Medicaid fraud, Minnesota fraud, California wealth tax, 340B program, drug arbitrage, hospital consolidation, site neutral payments, commercial mix, Medicare Trust FundAbout Our Guest | Ryan Long is a health policy expert with experience on Capitol Hill, including years in the Speaker's office and on the House Energy and Commerce Committee. He is affiliated with Paragon Health Institute and the University of Southern California.CreditsSponsor: Survivors for SolutionsExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Julie Riga, Stay on Course Studios, https://www.stayoncourse.studio

An episode pulled from the archives, Joe Grogan and Eric Ueland welcome Dr. Tevi Troy, former Deputy Secretary of Health and Human Services, presidential historian, and best selling author of Fight House: Rivalries in the White House from Truman to Trump. First aired in February 2023 at the midpoint of the Biden administration, this conversation diagnoses how White House infighting actually works, why the Biden team leaked so much less than its predecessors, and what discipline does and does not buy a president.From there the conversation turns to the machinery of the State of the Union, why the speech always collapses into a laundry list, and how Ronald Reagan invented the pageantry that every president has copied since. Troy then makes the bipartisan case for reforming the Centers for Disease Control, arguing for a congressional charter and a sharper pandemic mission separate from behavioral health. Along the way Joe, Eric, and Tevi cover Lyndon Johnson and Vietnam, Ed Koch and the art of criticizing opponents without alienating voters, the real origin of the Bull Connor line in Biden speeches, and why Troy believes the Republican party has a brighter future after Trump than the Democrats have after Biden.TIMESTAMPS0:00   Tevi Troy on a brighter Republican future after Trump0:47   DC EKG intro1:10   Joe and Eric welcome Tevi Troy, refill context from February 20233:00   Why the Biden White House leaks far less than Trump's did6:15   Neera Tanden, Afghanistan, and where the grumbling did surface9:30   Is the press softer on Democratic administrations12:10   Lessons from the hyper disciplined Bush 43 operation15:00   Friction as a feature: Johnson, Ford, and creative tension18:20   Johnson, Vietnam, and the limits of dominating Congress21:00   Biden faces a Republican House and a debt ceiling fight24:15   How a State of the Union actually gets built27:30   Why every State of the Union becomes a laundry list30:45   Reagan, Lenny Skutnik, and the birth of pageantry33:50   The case for reforming the CDC with a congressional charter36:20   Behavioral health versus the pandemic mission39:10   Ed Koch, Carter, and criticizing without alienating voters41:40   Where Meacham's Bull Connor line came from44:30   Troy's path to DC: AEI, Ben Wattenberg, and the PhD47:15   The conservative movement in flux and the future of the parties48:33   Wrap upABOUT OUR GUESTDr. Tevi Troy is a presidential historian, best selling author, and former Deputy Secretary of the Department of Health and Human Services. An insider's insider in Washington, he warned of US vulnerability to coronavirus in 2016 and has since written widely on the failures at the CDC. He began his career at the American Enterprise Institute working for Ben Wattenberg, earned a PhD from the University of Texas at Austin, and served in a range of roles in the George W. Bush administration, including at the Domestic Policy Council. He is the author of Fight House: Rivalries in the White House from Truman to Trump, What Jefferson Read, Ike Watched, and Obama Tweeted, and Intellectuals and the American Presidency, along with more than four hundred articles.CREDITSPodcast: DC EKG with Joe GroganEpisode: 137bGuest: Dr. Tevi Troy, former Deputy Secretary of Health and Human ServicesSponsor: Survivors for Solutions, https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios, https://www.stayoncourse.studio

Dr. Jay Bhattacharya on COVID-19 Seroprevalence, Natural Immunity, and the Great Barrington Declaration (Originally Aired July 20, 2023)This episode originally aired on July 20, 2023, the same day Stanford University President Tessier-Levine was forced to resign. Dr. Jay offers detailed commentary on the hostile work environment at Stanford and how government, big tech, and academia conspired to suppress scientific voices.Episode DescriptionIn this wide-ranging conversation, Joe Grogan and Eric Ueland sit down with Dr. Jay Bhattacharya to discuss his groundbreaking work on COVID-19 seroprevalence studies, the suppression of natural immunity data, and the origins of the Great Barrington Declaration.Dr. Bhattacharya shares his immigrant family story and early recognition that COVID-19 was far more widespread than official counts indicated. He conducted one of the first seroprevalence studies in April 2020 in Santa Clara and Los Angeles Counties, using antibody test kits provided by Major League Baseball, and found that the disease was 40 to 50 times more common than reported cases.The episode covers the intense backlash Dr. Bhattacharya faced for publishing these findings, including death threats, racist attacks, and institutional pressure from Stanford to suppress the research. He discusses how public health authorities suppressed evidence of natural immunity, the unethical decision-making by officials like Tony Fauci and Debbie Birx, and the formation of the Great Barrington Declaration.Dr. Bhattacharya details the coordinated campaign against him, censorship on social media, including Twitter blacklisting, federal government threats to ensure censorship, and the terrible price paid that will echo through generations. He reflects on the failures of scientific institutions and the reforms needed to restore public trust in science.Key Timestamps4:27 Background: born in India, immigrant family, father was a rocket scientist14:07 COVID enters consciousness: late December 2019, early January 202016:47 Wall Street Journal op-ed calling for seroprevalence studies19:06 Major League Baseball provides 10,000 antibody test kits20:30 Study results: 3 percent of Santa Clara had COVID by April 202026:12 Death threats, racist attacks, and pressure from Stanford34:51 Evidence of natural immunity being suppressed by Fauci and Birx39:52 Genesis of Great Barrington Declaration, October 202050:10 Hostile work environment at Stanford and Tessier-Levine impact56:44 FOIA requests revealing government targeting1:00:16 Twitter blocklist discovery and Elon Musk's Twitter Files1:05:00 Reform is needed in the scientific community to restore public trustAbout the Guest (at time of recording, July 2023)Dr. Jayanta Jay Bhattacharya is a Professor of Health Policy at Stanford University's School of Medicine and a Senior Fellow at the Hoover Institution. He holds an MD and a PhD in Economics from Stanford. Born in Kolkata, India, he immigrated to the US at age four. His research focuses on the health and well-being of vulnerable populations. He has published over 160 peer-reviewed articles and is the author of a leading textbook on health economics. Dr. Bhattacharya co-authored the Great Barrington Declaration and is a co-founder of the Academy of Science and Freedom.Dr. Jay's Current Role (June 2026)Since this episode was recorded in July 2023, Dr. Bhattacharya has assumed significant leadership roles in the federal government. He is the 18th Director of the National Institutes of Health (NIH), confirmed March 25, 2025, and took office April 1, 2025. As of February 18, 2026, he also serves as Acting Director of the Centers for Disease Control and Prevention (CDC), bringing his emphasis on scientific integrity and evidence-based policy to these critical positions.Podcast: DC EKG with Joe GroganGuest: Dr. Jay BhattacharyaHost: Joe Grogan and Eric UelandSponsor: Survivors for SolutionsExecutive Producer: John CZ

DC EKG with Joe Grogan Episode 137: Tax Expenditures, 340 B Drug Pricing, and Kidney Donation Reform Air Date: June 15, 2026 Episode DescriptionIn this episode, Joe Grogan sits down with Dr. Ike Brannon, President of Capital Policy Analytics and Senior Fellow at the Jack Kemp Foundation, to discuss hidden tax expenditures, the 340 B drug pricing program, and innovative solutions to the kidney shortage crisis. Dr. Brannon brings decades of Capitol Hill experience, including roles as chief economist of the House Energy and Commerce Committee and senior advisor to Senator Orrin Hatch. He and co-author Tony LoSasso recently published groundbreaking research in Health Affairs Forefront arguing that the 340 B drug pricing program should be classified as a hidden tax expenditure costing the federal government 15 to 20 billion dollars annually. The conversation covers how the 340 B program evolved from providing discounted drugs to uninsured patients into a massive subsidy for nonprofit institutions with little benefit to poor patients. Dr. Brannon explains how the same drug acquired at a 340 B discount often results in full commercial copays for patients. Joe and Dr. Brannon explore other problematic tax expenditures including the mortgage interest deduction, employer health insurance exclusion, and credit union tax breaks. The episode pivots to Dr. Branons passionate work on kidney donation reform. Forty-five thousand Americans die annually from end stage renal failure due to kidney shortage, disproportionately affecting African Americans. Dr. Brannon advocates for fully reimbursing kidney donors for all expenses. Key Topics340 B drug pricing program, tax expenditures, pharmaceutical discounts, nonprofit hospitals, mortgage interest deduction, kidney donation, end stage renal failure, organ shortage, entitlement reform, social security, Medicare, federal deficit, health economics Key Timestamps 0:00 Opening: What should be in a reconciliation bill?4:38 The 340 B drug pricing program explained13:54 How the 340 B discount does not reach patients20:13 Mortgage interest deduction: the most irritating tax break31:00 Prospects for reconciliation under Trump administration34:57 The kidney donation crisis: 45,000 deaths per year39:02 How kidney donation reimbursement would work40:00 Would you allow kidney sales? The ethical debate45:13 Final thoughts About the GuestDr. Ike Brannon is President of Capital Policy Analytics and Senior Fellow at the Jack Kemp Foundation. He holds a PhD in Economics from Indiana University. Dr. Brannon served as chief economist of the House Energy and Commerce Committee, senior advisor to Senator Orrin Hatch on tax and trade policy, and has worked at the Congressional Joint Economic Committee, Treasury Department, and for the McCain presidential campaign. He is founder of the Prosperity Caucus and focuses on growth-oriented economic policy and healthcare innovation. Featured ResearchThe 340 B Drug Pricing Program is a Hidden Tax ExpenditureHealth Affairs Forefront, April 24, 2026Co-authored by Ike Brannon and Tony LoSassohttps://www.healthaffairs.org/content/forefront/340b-drug-pricing-program-hidden-tax-expenditure Podcast: DC EKG with Joe GroganEpisode: 137Guest: Dr. Ike Brannon Sponsor: Survivors for SolutionsProducer: Stay on Course StudiosExecutive Producer: John CZ Czwartacki, DC EKG Podcast

DC EKG with Joe GroganThe Economics of Ozempic and Other Weight Loss DrugsEpisode 136.5 (“Prescription Refill” – A replay from the archives)Original Air Date: May 2024In this episode, Joe Grogan welcomes Ben Ippolito, Senior Fellow in Economic Policy Studies at the American Enterprise Institute, to discuss the rapidly evolving economics of GLP-1 weight loss drugs like Ozempic and Wegovy.Ben explains the two main competitors in this market—Novo Nordisk's Ozempic and Wegovy versus Eli Lilly's Mounjaro and Zepbound. Revealing how insurance coverage decisions drive pharmaceutical marketing strategy.The conversation reveals a critical irrationality in Medicare policy: the statutory prohibition on covering weight loss drugs despite their profound clinical and quality-of-life benefits. Yet these same drugs are covered for diabetes and cardiovascular risk reduction.Ben explores the surprising economics of drug pricing through gross-to-net pricing—the massive gap between list prices and what insurers actually pay through rebates and discounts.The episode examines critical implications of the Inflation Reduction Act's price negotiation provisions. Once Medicare negotiates Ozempic's price, that same price applies to all products using the same active ingredient. This creates cascading market effects: competitors must match those prices to remain on formularies, new entrants face lower pricing power even if clinically superior, and pharmaceutical companies may abandon promising programs due to regulatory uncertainty.Ben argues Congress doesn't need to act immediately to expand Medicare coverage, but likely will within a few years.Joe and Ben discuss unintended consequences of government price regulation, including effects on innovation and drug development pipelines. They explore how price controls announced before elections affect pharmaceutical strategy and development timelines.Concluding with Ben's research on Medicare Advantage and why both Democrats and Republicans scrutinize this private alternative to traditional Medicare. With over 50 percent of seniors enrolled in Medicare Advantage plans, bipartisan interest in reform is reshaping healthcare policy conversations on Capitol Hill.Key TopicsGLP-1 drugs, Ozempic, Wegovy, Mounjaro, Zepbound, weight loss medications, obesity treatment, Medicare coverage, drug pricing, Inflation Reduction Act, pharmaceutical competition, rebates, gross-to-net pricing, health economics, cardiovascular benefits, diabetes treatment, Medicare Advantage, healthcare policy, innovation incentivesKey Timestamps00:00 Cold Open: "Turned Up to 11"00:24 Welcome to DC EKG00:46 Meet Ben Ippolito (AEI)03:48 The GLP-1 Landscape: Ozempic, Wegovy, and the Field05:04 One Drug, Two Names06:45 Medicare's Weight-Loss Coverage Ban07:21 Blockbusters and Big Effect Sizes09:32 Why Isn't Congress Acting?10:17 Why It Costs Less Than You Think12:34 The Coverage Irrationality14:05 Quality of Life as a Real Benefit15:17 Beyond Weight: Cravings and Addiction18:21 Devil's Advocate: Why Cover It At All?19:48 Gross-to-Net and the Rebate Problem22:41 Why Can't You Just Pay Cash?25:43 The IRA and the Ozempic Price Cut27:32 One Ingredient, One Price30:10 Unintended Consequences in Part D34:01 New Competitors and Killed Programs38:03 What's Next: Medicare Advantage42:04 Wrap-Up and CreditsAbout the Guest(As of May 2024) Ben Ippolito is a Senior Fellow in Economic Policy Studies at the American Enterprise Institute. He holds a PhD and Master's degree in Economics from the University of Wisconsin-Madison and a Bachelor's degree in Mathematics and Economics from Emory University. Ben examines drug pricing policy, Medicare Advantage, and healthcare innovation economics with regular engagement with Congress.Podcast: DC EKG with Joe GroganGuest: Ben IppolitoSponsor: Survivors for SolutionsProducer: Stay on Course StudiosExecutive Producer: John CZ Czwartacki, DC EKG Podcast

In Episode 136 of DC EKG, Joe Grogan hosts Tom Barker, a top drug-pricing attorney at Foley Hoag and former acting general counsel of Health and Human Services (HHS) under the Bush administration. Tom helped implement Medicare Part D and now advises drugmakers and policymakers on complex pricing issues. The episode traces 20 years of policy: what went right with Part D, what the Inflation Reduction Act (IRA) did, and what effective policy should look like.Tom explains that Part D's success rested on three pillars: private plans only, limited government control over benefit design, and a non-interference clause barring the government from intervening in negotiations among plans, pharmacies, and manufacturers. Competition worked and premiums stayed low, until the government asserted more control and weakened those pillars. The IRA, he argues, was a 16-year Democratic effort to repeal non-interference, creating price controls disguised as negotiations.The Trump administration has taken a different tack, focusing not on the IRA but on MFN and Globe Guard models pegged to other developed countries. Tom also breaks down the 340B program, now the country's second-largest expenditure program, and the fight between manufacturers and covered entities over contract pharmacies.His prescription is simple: let competition work. Speed FDA approval of generics and biosimilars, and trust the marketplace over price controls. He points to hepatitis C, where prices fell sharply once competition entered.In This ConversationThe three pillars that made Part D successful for 20 yearsHow non-interference kept government from setting drug pricesThe IRA as a 16-year Democratic push to repeal non-interferenceWhy Tom calls the IRA price controls disguised as negotiationsThe Trump administration's focus on MFN and Globe Guard pricing340B and the battle between manufacturers and covered entitiesThe Chevron repeal's impact on drug pricing lawHRSA's proposed rebate model and ongoing 340B litigationWhy effective policy means competition, not controlsTom's work helping North Korean defectors and refugeesKey Timestamps1:51 Tom's background at HHS and CMS2:30 The three pillars of Part D's success5:10 Why Democrats wanted to repeal non-interference5:55 Ted Kennedy's compromise and bipartisan votes11:38 The IRA as a 16-year repeal attempt12:03 What the IRA changed in Part D15:02 IRA negotiations vs. real negotiations16:25 How the excise tax makes it no real negotiation21:32 Trump's focus on MFN and Globe Guard25:37 340B's history back to 199128:45 340B as the second-biggest expenditure program29:30 Manufacturer vs. covered-entity acrimony33:18 The Chevron repeal's impact on pricing34:54 HRSA's rebate model, the next step on 340B35:40 The lawsuit over "patient" in 340B38:18 Tom's advice: let competition work39:30 Hepatitis C: competition drives prices down40:34 Competition for gene therapies and CRISPR41:36 Tom's work for North Korean defectors44:49 Sponsoring Free North Korea RadioMedicare Part D, drug pricing policy, Inflation Reduction Act, non-interference clause, 340B program, MFN pricing, Globe Guard pricing, pharmacy benefit managers, covered entities, contract pharmacies, biosimilars, generics, federal drug pricing, government price controls, Tom BarkerAbout the GuestTom Barker is a partner at Foley Hoag in Washington, DC, and one of the country's top drug pricing attorneys. He served as acting general counsel of HHS and chief legal officer at CMS under the Bush administration, where he helped implement Part D from its inception. He is now a go-to expert on drug pricing, and helps North Korean defectors navigate US immigration law.Podcast: DC EKG with Joe Grogan Episode: 136 Guest: Tom Barker Sponsor: Survivors for Solutions - https://survivorsforsolutions.org Executive Producer: John "CZ" Czwartacki, DC EKG Podcast Producer: Stay on Course Studios - https://www.stayoncourse.studio