Fighting Healthcare's Misaligned Incentives

00:00 Introduction and background

• How HSAs and price transparency shaped Scott’s view on incentives

• Why independent TPAs control more of healthcare than they realize

00:41 WLT’s buy vs build strategy

• Choosing partnerships over trying to build everything

• How “implementation purgatory” costs more trust than bad pricing

• Customization beating rigid plan design in the real world

04:04 Primary care and incentives

• Why primary care turned into a transaction instead of a relationship

• How Direct Primary Care cuts downstream costs people fail to measure

06:09 AI in healthcare

• Providers are using AI to increase billing leverage

• Payers need AI defensively or they are guaranteed to overpay

09:02 Member navigation and decision support

• Most employees do not understand how to use their health plan

• Early guidance can stop unnecessary surgeries and escalation

10:01 Point solution fatigue

• Why guaranteed ROI pitches have lost credibility

• Trust still matters more than pitch decks and cold calls

• Reputation compounds slowly and disappears instantly

12:05 Lightning round

• The influence of Scott’s father on leadership and discipline

• Which healthcare middlemen need to be eliminated