The $500 billion healthcare problem nobody talks about w/ Mike Desjadon, CEO of Anomaly Health

In this episode of Second Opinion, Christina Farr and Luba Greenwood chat with Mike Desjadon, CEO of Anomaly Health, about the state of American healthcare heading into 2025. Mike breaks down how health insurance companies actually make money and explains why we spend $500 billion just processing medical bills. They discuss the security concerns around J.P. Morgan Healthcare Conference after a tumultuous 2024, explore why pharma companies really aren't making money from vaccines, and unpack how Ozempic transformed endocrinology from an overlooked specialty to the most coveted medical fellowship in the country. The conversation wraps with realistic predictions for healthcare in 2025. Thanks to our sponsor, Midi Health.

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YouTube: https://www.youtube.com/@ModernRelationshipsPod

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LINKS: 

Anomaly: https://www.findanomaly.com/

Second Opinion Newsletter: https://secondopinion.media/ 

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FOLLOW:

https://www.linkedin.com/in/mike-desjadon-4a0a21a/

https://www.linkedin.com/in/christinafarr/

https://www.linkedin.com/in/lubagreenwood/

https://www.linkedin.com/in/ashzenooz/

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HIGHLIGHTS FROM THE EPISODE:

• 2024 was marked by several major healthcare events including a massive Change Healthcare cybersecurity breach, increased PBM scrutiny, Trump's election, and the tragic shooting of UnitedHealthcare CEO Brian Thompson.
• While security concerns exist for the upcoming JP Morgan Healthcare Conference, high hotel costs remain the primary deterrent for attendees, with many companies opting for nearby meetings instead of conference attendance.
• The Change Healthcare hack exposed a critical transparency issue when Americans learned that a single company had access to half of the nation's health data.
• The U.S. healthcare system spends $4 trillion annually, with $500 billion going to administrative costs in a complex third-party payment system where insurance companies operate on 4-6% margins and health systems on 0-4% margins.
• While the U.S. healthcare system is more expensive and less efficient than other countries', it offers advantages like shorter wait times and fewer age-based restrictions on procedures.
• The pharmaceutical industry faces significant challenges in drug development, with high failure rates and complex manufacturing processes for modern drugs, while vaccines typically don't generate major profits.
• For 2025, industry experts predict an increase in biotech IPOs, expansion of Medicare Advantage, potential separation of PBMs from vertically integrated entities, and greater scrutiny of PBM relationships by employers.
• The healthcare industry needs better transparency in pricing and in insurance plan coverage.
• The system incentivizes volume-based care rather than preventive care, which is evident in both payment structures and professional specialization trends.
• The rise of GLP-1 drugs has transformed endocrinology from one of the least desired medical specialties to the most coveted fellowship program.