Out of Patients
with Matthew Zachary
Welcome to 2026: The Year of the Patient where the sick shall inherit the ballot.
The Healthcare System Works Exactly as Designed. Cancer Patients Pay the Price.
Cancer patients increasingly absorb the financial risk of surviving disease in America. A brain cancer survivor examines how healthcare incentives, insurance design, and policy decisions shifted instability onto patients and families while institutions protect margins.
Out of Patients EP444: Discharge Instructions Not Included: Shlomit Liberty
At 19, Shlomit Liberty lost speech and got sent home with “stress.” Now she spends 15 to 20 hours a week guiding families through hospital chaos. This episode exposes how discharge, insurance rules, and system incentives leave patients confused and paying the price.
Hospitals and Insurers Keep Blaming Each Other While Patients Finance the Entire System
Hospitals blame insurers. Insurers blame hospitals. Patients finance the entire system through premiums, deductibles, debt, and confusion. Matthew Zachary examines the incentive structures, financial flows, and institutional dependencies that keep American healthcare expensive, opaque, and exhausting.
Cost Plus vs Walgreens: My 90 Day Prescription Cost Less Without Insurance
I paid $13.18 for a 90 day prescription through Cost Plus. Walgreens charged $30 with insurance. Same drug. Same supply. This is what PBMs do to pricing and why transparency exposes the middlemen.
What Happens If More Patients Appeal Insurance Denials?
Only 0.2% of patients appeal insurance denials, yet 80% succeed. This article examines how even small increases in appeals could shift insurer behavior, raise costs, influence Wall Street expectations, and reshape the economics of American healthcare.
Healthcare Is a Private Tax Triggered by Diagnosis
Gallup reports 82 million Americans cut back on daily life to afford healthcare. Coverage shifts financial risk to families through deductibles and prior authorization. Diagnosis now operates like a private tax on survival and forces tradeoffs across work, housing, and retirement.
The Health Insurance Industry is the new Joe Isuzu #TrustMe
Blue Cross Blue Shield says insurers protect patients from high drug prices. The real world shows delays, denials, and blame shifting while patients wait, appeal, and deteriorate. A closer look at how insurers deflect responsibility in the drug pricing debate.
Breaking Up Big Medicine
The new bipartisan proposal to separate insurers, PBMs, and providers targets the financial structure behind rising costs and denials. This piece explains how ownership concentration reshaped care, why regulation failed, and what structural separation could change for patients.