Your health plan costs the same as a Tesla Model Y. I sat down with Ali Diab, CEO and co-founder of Collective Health, to find out what Collective Health is doing to fix it. Ali started the company after his own hospital claim got denied, and has spent the decade since building what he calls the “Stripe” of healthcare benefits — for employers today, and potentially insurers and health systems tomorrow. This episode hits the affordability crisis head-on. Ali makes the case that health insurance itself is the real inflationary catalyst in American healthcare. Ali doesn't do the polite version. He calls the MLR a cost-plus contract, compares network "discounts" to markdowns off the Neiman Marcus price, and told me about the time he was charged $340 in coinsurance for a $125 knee brace on his own company's plan. We dig into why self-insurance and direct contracting are eating the fully-insured market alive, why small employers are legally boxed out of self-funding, and why he thinks healthcare pricing needs an SEC. Also: World Cup takes. Ali's a winger-turned-number-nine and I broke two leg bones playing this sport, so we earned the tangent. Listen on Apple: Listen on Spotify: TIMESTAMPS (04:31) A denied hospital claim, a Stanford doc spending more time fighting insurers than seeing patients, and the founding of Collective Health (08:34) Your family's premium buys a Tesla Model Y every year — and the MLR is the $600 Navy toilet seat problem in disguise (16:35) America is over-insured: stop running windshield wipers through car insurance (and birth control through health plans) (18:55) Network discounts are markdowns off the Neiman Marcus price — the PBM rebate illusion explained (20:19) From 25 lives to Walmart: the self-funding playbook carriers lobbied your state to keep away from you (27:24) The $340 knee brace story (retail price: $125 — and no, he couldn't bring his own) (37:35) Inside the 3.9% vs. 9% trend gap: how routing members in real time actually bends cost (52:44) Give healthcare an SEC: why Ali thinks price discrimination in care delivery is a solved problem we refuse to solve

I fought to ensure health insurance can’t drop you for pre-existing conditions and preventative screens are covered. It's critical we protect consumers so insurance companies can't take advantage of Floridians in their time of need.

In 2019 my health insurance was $210 a month. Never filed a single claim. Today it’s $480 a month. Still haven’t filed a claim. Because the deductible is $6,500. I pay $5,760 a year before they cover anything serious. So I don’t go. I ignore the thing on my shoulder that’s probably nothing. I Google symptoms at 2am instead of calling a doctor. I pray nothing happens. Because the insurance I pay for every single month is the thing standing between me and care I can actually afford. That’s not insurance. That’s a very expensive maybe.

The surge in US health insurance costs shows no signs of slowing: Health benefit costs per employee are expected to rise +6.7% YoY in 2026, to at least $18,500, the biggest annual increase in 15 years. This is more than double the increase seen in 2019 or 2022. Furthermore, health insurers are expected to raise the cost of employer group plans by over +6.0% for the 4th consecutive year. In response, ~66% of large US firms plan to increase monthly employee premium contributions in 2027. Workers who frequently visit doctors and fill prescriptions could see healthcare costs rise as much as +8.0% YoY. US healthcare costs have never been higher.

Main Street Texans Back Abbott's Health Insurance Plan. It will lower the cost of health insurance for the average family by more than $1,000. Save business almost 20%. Add more than a million Texans to the insured rolls. via @TBBusiness

Obamacare was supposed to make health insurance more affordable. Instead, average monthly premiums more than doubled — from $232 in 2013 to $476 in 2017. Last year, they reached $619. Americans deserve better than ever-higher premiums.

i called to cancel my health insurance because i couldn’t keep affording it. the rep asked why. i said paying $500 a month for a plan with a $6k deductible doesn’t even feel like insurance anymore. it just feels like paying monthly to still be financially ruined if something happens. she didn’t really have a response.