DC EKG

Obamacare, HSAs, and Reference Pricing with Dr. John Goodman

DC EKG

Show Notes

In Episode 131 of DC EKG, Joe Grogan sits down with Dr. John Goodman to discuss what both parties continue to get wrong about healthcare, why patient incentives still matter, and how market-based reforms could lower costs and improve access. Drawing on decades of work in health economics and policy, Dr. Goodman explains how special interests helped shape Obamacare, why supply-side constraints still distort care, and why patients are too often left out of the policymaking process.

The conversation then turns to Health Savings Accounts, Medicaid reform, emergency room overuse, and why policymakers remain so resistant to giving patients more control over healthcare dollars. Dr. Goodman also outlines his view that self-directed care and consumer choice can improve value and expand access, especially for vulnerable populations.

In the second half, Joe and Dr. Goodman dive into reference pricing as a major reform idea. Using real-world examples, they discuss how clearer prices and patient-driven decision-making could create more meaningful competition across healthcare markets. The episode closes with a broader conversation on bipartisan reform, the tax code, and why durable change remains so hard to achieve in Washington.

In This Conversation

What both parties keep getting wrong about healthcare

How special interests shaped Obamacare and why patients were left out

Why HSAs remain controversial and what they change about incentives

Medicaid reform, emergency room use, and patient access

How self-directed care can improve outcomes and satisfaction

What reference pricing is and why it could create real competition

Why bipartisan healthcare reform keeps breaking down in Washington

Timestamps0:00 How special interests shaped Obamacare0:46 Joe welcomes Dr. John Goodman1:09 Dr. Goodman’s background and the origins of HSAs5:22 What both parties get wrong about healthcare7:36 Why physician supply stays restricted9:26 Spending more without getting healthier14:16 What Washington should actually be debating15:52 Insurance that meets patients’ needs20:06 HSAs and consumer-directed care22:29 Why Medicaid patients rely more on emergency rooms24:50 Medicaid reform and letting patients pay the difference28:07 Self-directed care and “Cash and Counseling.”29:35 Reference pricing explained32:14 How reference pricing could reshape insurance markets36:06 Why Dr. Goodman is optimistic40:36 The tax code and healthcare policy44:22 Where to find Dr. Goodman’s work45:42 Outro

Obamacare, health savings accounts, HSA, John Goodman, Joe Grogan, healthcare reform, healthcare policy, Medicaid reform, emergency room visits, patient incentives, consumer-directed care, reference pricing, tax policy, bipartisan reform, healthcare economics

About Our GuestJohn C. Goodman is President of the Goodman Institute for Public Policy Research and is widely known for his work in health economics, Health Savings Accounts, and consumer-directed healthcare reform.

Podcast: DC EKG with Joe GroganEpisode: 131Guest: John C. GoodmanSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio

More from DC EKG

Sep 30, 2026

DC EKG with Joe Grogan DC EKG Ep 140 | Joe Grogan & Dr. David Eagle: The Hospital Squeeze Guest: Dr. David Eagle, President, American Independent Medical Practice Association

Sep 28, 2026

Joe Grogan talks with John Desser, VP and Head of Government Affairs at Health Equity, about market-based healthcare and why Health Savings Accounts (HSAs) may be its future. John's 35-year career runs from an internship in Senator John McCain's office through the Bush administration, eHealth, and now Health Equity. He recounts how the ACA's first draft nearly wiped out private online insurance marketplaces, why healthcare.gov stumbled, and how consumer control can fix healthcare's misaligned incentives. He also reflects on Ron Wyden's universal coverage plan without a mandate, Ted Kennedy's role in bipartisan reform, McCain's skinny repeal vote, and Trump's "give the money to the people" approach.

Sep 28, 2026

Elizabeth Chamblee Birch, law professor and author of The Pain Brokers, exposes a coordinated healthcare fraud scheme targeting over 100,000 women. Stolen HIPAA-protected health records were weaponized by call centers in India and South Florida to convince women they needed emergency mesh removal surgery. Many women were left permanently incontinent after unnecessary procedures. The scheme involved call centers using stolen medical data, South Florida surgical operations, lawyers creating hidden liens, and litigation funders profiting from women's suffering. Birch introduces the villains: Vince Chabra (online pill mill founder), Blake Barber (travel concierge), and complicit doctors. She also highlights heroes: Barbara Bennis (defense attorney who uncovered the conspiracy) and J.R. Baxter (young plaintiffs lawyer who fought back). The episode reveals how electronic health record systems enabled massive data breaches, how private equity infiltrated the legal system, and what reforms are desperately needed to prevent future schemes.

Sep 7, 2026

Guest: John Bertrand, former Digital Diagnostics

See all episodes →