This week, host Chuck Melendi sits down with Val Barschaw, author of the new book Surviving the Hospital: Six Secrets Every Patient Should Know and longtime patient advocate. Drawing from her husband’s decade-long journey to a heart transplant and more than 25 years of post-transplant care, Val reveals practical, life-saving strategies for anyone navigating a hospital stay.
Her message is simple but transformative: patients must STOP being passive recipients and become active partners in their own care.
Together, Chuck and Val break down 6 key ways that patients and families can reduce hospital errors, advocate effectively, and prepare for the unexpected—turning the unknown into clarity and control.
About Val’s Book:
Surviving the Hospital: Six Secrets Every Patient Should Know is a concise, empowering guide that equips patients and caregivers with the tools to stay safe, confident, and informed in any hospital setting.
➡️ Learn more and get your copy at www.hospitaltohealth.com.
Resources Mentioned:
• Book: Never Pay the First Bill by Marshall Allen — a must-read for handling medical billing disputes.
• Advocacy Resource: Greater National Advocates — find a patient or billing advocate near you.
• Chuck’s Website: DisruptiveDialogue.org— access templates for contacting legislators and healthcare advocacy tools and so much more.
Subscribe & Share:
If this episode opened your eyes or could help someone facing a hospital stay, please subscribe, rate, and share! Together we can demand better—and make healthcare work for everyone.
Host Chuck Melendi talks with Chet Pietras and Ethel Owen about Medicare and Medicare Advantage coverage and how to make confident choices during open enrollment. They unpack the key differences between Medicare Advantage and Traditional Medicare, offering practical advice for seniorsand healthcare professionals alike.
They share insights on plan costs, provider networks, and how to make smart, confident choices during Open Enrollment (Oct 15 – Dec 7).
🧭 What You’ll Learn
The 4 Parts of Medicare
How to compare Medicare Advantage vs. Traditional Medicare
Financial and network factors that affect your plan
Why guidance from a trusted professional matters
✅ Action Items
Educate yourself on coverage differences and costs
Partner with a licensed insurance agent for guidance
Compare plans locally to fit your specific needs
Empower yourself and those you know to be informed health advocates
🔗 Resources
Medicare.gov – Official Plan Finder
CMS – Open Enrollment Information
SHIP – State Health Insurance Assistance Programs
Connect with Chet Pietras (Florida Residents): Phone: 727-946-8294 Email: cpietras@sisfl.com https://www.yourmedplan.com/
Slides from this episode are at disruptivedialogue.org/getinvolved
📱 Connect & Subscribe
Stay informed with Disruptive Dialogue — real conversations about healthcare reform and smart decision-making.
Follow on Apple Podcasts, Spotify, or YouTube for newepisodes every month.
Choosing health insurance doesn’t have to be overwhelming - but it can be! In this episode, Chuck is joined by health insurance advisor Chet Pietras, who brings 40+ years of experience helping individuals and families make smartcoverage decisions.
Together, they cover:
In these 50 minutes, you’ll understand how to prepare for openenrollment, what factors really matter in choosing a plan, and how to avoid costly pitfalls.
Was this the resource you needed? If so, please share with a friend who needs to know. And give us a like!
How do you cut through the complexity of U.S. private health insurance? In this episode of Disruptive Dialogue, Chuck shares actionable strategies to help you make faster and smarter choices, lower your costs, and take full advantage of the benefits you already pay for.
Learn:
Key timelines for open enrollment and when insurers release plan details
Which preventive services are 100% covered at no cost under the ACA & employer plans
Practical tips for fighting denials and advocating for yourself
A scenario-based dive into how tools like ChatGPT can simplify insurance research and decision-making. Mind-blowing!
Whether you’re choosing your first plan or reevaluating coverage this fall, this episode arms you with the knowledge and resources to take control of your healthcare decisions.
👉 Subscribe to catch our upcoming episodes featuring experts with more tools, plus the fascinating guests in past and future seasons!
In this episode of Disruptive Dialogue, Chuck continues hisHealthcare 101 series on private insurance. Healthcare literacy matters in our complicated system, and learning the basics makes all of us better consumers. Listen in!
After recapping the basics of premiums, deductibles, and copays from the last episode, he dives into the barriers that keep patients from accessing the care they need—and how to overcome them. This episode equips you with practical knowledge and strategies to advocate for yourself and your family.
Learn About
Common barriers to accessing care with private insurance
How/why insurers use administrative tools like prior authorization and step therapy
Ways patients can appeal denials and delays
Strategies to prepare during enrollment to avoid costly surprises
The pros and cons of private insurance from the patient’s perspective
Key Terms & Definitions
Premium: The fixed monthly payment you make for insurance coverage, whether or not you use services.
Deductible: The amount you pay out of pocket before insurance begins to cover costs.
Copay/Coinsurance: Your share of the cost for services or prescriptions after meeting your deductible.
Prior Authorization: Requirement for insurer approval before certain tests, drugs, or procedures are covered.
Step Therapy (Fail-First Policy): Policy requiring patients to try lower-cost drugs or treatments before moving to more expensive options.
High Cost Sharing: Large deductibles, copays, or coinsurance amounts that make care unaffordable.
Copay Accumulator / Maximizer: Insurer policies that absorb drug manufacturer copay assistance, leaving patients with higher costs once assistance runs out.
Non-Medical Switching: When insurers force patients to change medications for cost reasons rather than medical ones.
Formulary: A list of prescription drugs covered by an insurance plan, often with restrictions.
Quantity Limits: Restrictions on how much medication can be dispensed at one time.
The Takeaway
Private insurance can provide choice and financial protection, but navigating its barriers requires preparation, persistence, and advocacy. Be prepared!
Season 2 of Disruptive Dialogue will give you the tools you need, so subscribe today, and share with your friends and family before open enrollment season starts.
Stay Connected!
Visit https://www.disruptivedialogue.org/get-involvedfor episode slides and more resources.
Have questions or feedback? Reach out through the contact page.
Subscribe to our newsletter for weekly updates right to your inbox.
If you found this episode helpful, share it with a friend or colleague who could benefit.
Subscribe to Disruptive Dialogue with Chuck Melendi so you don’t miss the next episode in the Healthcare 101 series.
Welcome to Season 2 of Disruptive Dialogue – Healthcare 101
Healthcare literacy matters now more than ever. With open enrollment right around the corner, and insurance premiums on the rise, this season is your essential guide to becoming a smarter, more confident healthcare consumer.
In this episode, Chuck breaks down the confusing world of health insurance—from skyrocketing premiums to enrollment deadlines—and gives you a practical roadmap to make informed decisions.
💡 What You'll Learn in This Episode:
• Why health insurance is so confusing—and how to simplify it• What preventive care really includes (hint: it’s often FREE)• How open enrollment periods work for Medicare, Medicaid, and ACA plans• The true meaning of premiums, deductibles, copays & out-of-pocket max• How your location and plan type can affect your monthly costs• Tips for choosing the right plan for your health and your wallet• Tools and strategies to compare plans and avoid costly mistakes
📌 Action Step:
1) Start reviewing your options early—ideally by September. Use healthcare.gov, your company HR, or consult a licensed broker to avoid last-minute decisions.
2) Share this with a friend who may be intimidated by choosing a policy
📊 Download the Show Slides for all the details:
https://www.disruptivedialogue.org/get-involved
▶️ Up Next:Chuck continues the conversation in the next episode with a deeper dive into private health insurance, employer-sponsored plans, and cost-saving strategies you don’t want to miss.
👍 Like and Subscribe so you don’t miss future episodes!
Why are so many doctors leaving private practice? Why does it take so long to get an appointment? In the final episode of Season 1, Chuck Melendi is joined by Dr. Andrew Weinstein, President-Elect (2027) of the American Academy of Dermatology, to share how Medicare cuts—and the outdated Physician Fee Schedule—are quietly breaking the healthcare system at its heart .
Dr. Weinstein explains how this Medicare pricing system hasn’t kept up with inflation in decades, and how private insurance companies follow Medicare’s lead—paying doctors less, while raising costs for patients. Meanwhile, Medicare Advantage plans rake in billions through upcoding and favorable selection, putting profits ahead of patient care.
What You Will Learn:
-Why doctors are burning out and closing their offices
-How Medicare and private insurance payments are linked
-What “Physician Fee Schedule” really means (and why it matters)
-How Medicare Advantage plans are overpaid—and under-delivering
-What happens if Congress doesn’t fix this soon
Resources:
To learn more about the Physician Fee Schedule for Medicaid, read this report from the Kaiser Family Foundation.
Take Action:
-Call your representatives and demand physician reimbursement that keeps pace with inflation.
-Visit disruptivedialogue.org to find your legislators, and for other advocacy resources
-Share this episode with family and friends—especially Medicare enrollees
-Leave us a rating and review to help others find this important conversation!
In today’s episode, Chuck takes you through some of the biggest healthcare headlines shaking the nation. From shocking lawsuits to tragic losses, Chuck reveals how powerful insurance companies and PBMs are being held accountable –and how much more needs to be done to reign them in.
Highlights include:
· The FTC’s damning report on pharmacy benefitmanagers
· BlackRock suing UnitedHealth—for being too generous
· A tragic asthma death caused by a $500 inhaler
· Medicare Advantage fraud costing billions
· Arkansas passing a bold law to ban PBM-ownedpharmacies
· A former lawmaker admitting Medicare Advantageis broken
Chuck doesn’t just rant—he gives you tools to fight back. Subscribe to his upcoming healthcare newsletter and learn how to contact your legislators directly.
Tap here to get involved → https://www.disruptivedialogue.org/.
Rate, follow, and share this episode if you believe patients come before profits.
An honest, intergenerational conversation about anxiety, parenting, and growing up in a world shaped by 24/7 news and screens.
In this deeply personal episode, Chuck Melendi is joined by his 27 year old daughter Crosby for a revealing dialogue about mental health.
They unpack Crosby’s journey with anxiety and depression—from early teenage struggles to breakthroughs in therapy—to explore how parenting, social media, and generational disconnects all shape the way we experience and talk about emotional wellness.
If you're a parent trying to understand your kids, a young adult navigating pressure and comparison, or simply someone looking to heal from the past and communicate better in the present—this conversation is for you.
This is not a clinical breakdown or challenge to the system—it’s a raw look at how mental health shapes families - and what healing can look like when you create a culture of open communication.
About Crosby
Crosby is a 27 year old content creator for YouTube and Instagram, @CrosbyGraceTravels, where she shares the highs and lows of full time travel and life as a digital nomad. She graduated magna cum laude from Elon University in 2020.
Book Mention
Yes Your Teen is Crazy by Dr. Michael Bradley is considered the gold standard of teen parenting books and reframed Chuck’sparenting strategy. Learn more about it at https://docmikebradley.com/dr-michael-bradley-books
Take Action!
Subscribe, rate, and review Disruptive Dialogue with Chuck Melendi wherever you listen.
Share this episode with someone who needs to hear it.
Visit disruptivedialogue.org for episode resources, to share your story, & for ways to get involved in reforming healthcare.
In Part 2 of this meaningful conversation, Chuck welcomes back Roaya Tyson, CEO of Gracepoint Wellness, to dig even deeper into the realities behind mental health care in America. Today we focus on mental health parity, the impact of the opioid crisis, and the personal and economic costs of inaction.
From treatment inequities to Medicaid reimbursement gaps and the economic burden of untreated illness, this episode is a sobering look at the policies and systems that need urgent reform.
Highlights & Takeaways
• Mental Health Parity Gaps: Despite laws mandating equal coverage, behavioral health services are still reimbursed at far lower rates than physical health services. Chuck and Roaya break down how that inequity plays out in practice—and what needs to change.
• Why Community Mental Health Centers Matter: Chuck and Roaya compare Community Health Centers (CHCs) to generalized hospitals, emphasizing the unique value of specialized care centers for behavioral health and substance use treatment.
• Profit vs. Purpose: A candid look at how publicly traded, for-profit healthcare entities differ from mission-driven nonprofits when it comes to patient outcomes, reinvestment, and care priorities.
• The Hidden Cost of Opioids: A recent Axios report estimates the total societal cost of just ONE opioid use disorder case to be nearly $700,000, with U.S. total costs projected to hit $4 trillion in 2024.
• Training Our Front Lines: ER doctors and primary care physicians are now often the first point of contact for mental health crises, yet most lack formal training in behavioral health. Roaya calls for mandatory mental health education in medical school.
• A Vision for Prevention: Why funding early intervention and outpatient services saves lives—and taxpayer dollars—compared to waiting until people reach crisis levels and require ER-level care.
• The Power of Merging Missions: Gracepoint (mental health focus) and The Cove (substance use focus) are coming together to form Ibis Healthcare, creating a unified system that can treat both conditions under one roof—removing silos and streamlining care.
• Florida’s First Women’s Psychiatric Hospital: Roaya shares details about Gracepoint’s newest initiative—one of fewer than a dozen facilities in the U.S. dedicated solely to women’s psychiatric needs.
Take Action!
Mental health care isn't just a personal issue—it's a policy issue. Visit DisruptiveDialogue.org to:
• Send pre-written advocacy letters to legislators
• Access resources for behavioral health reform• Share your own story and raise awareness
• Connect with Chuck for speaking engagements and consultation services
Be informed. Be loud. Be the change.
Coming Soon.....
In upcoming episodes, Chuck will explore the economics of health care, innovation in nonprofit delivery models, and the role of AI in mental health. Subscribe and stay tuned.
How can the USA be failing so many in mental health? In this candid episode, Chuck sits down with behavioral health CEO Roaya Tyson to explore the mental health crisis in America—and how we got here.
Roaya’s 20+ year journey from social worker to CEO gives her a rare vantage point on how behavioral healthcare has evolved, what’s still broken, and how she and her team at Gracepoint are fighting stigma, increasing access, and integrating care in revolutionary ways.
From the realities of cell phones in schools to what really happens during a Baker Act, Chuck and Roaya don’t hold back. Whether you're a parent, policymaker, provider, or just someone trying to make sense of the system—this one will leave you informed and inspired.
MEET ROAYA TYSON
Roaya Tyson is the CEO of Gracepoint Wellness, a community-driven healthcare organization in Tampa, Florida that delivers high quality patient care regardless of ability to pay. She began 23 years ago as a clinical social worker and advanced from clinical care to COO and ultimately assumed the CEO role in 2023. Gracepoint will merge with Cove Behavioral Health in July 2025 to become Ibis Healthcare, deepening access to mental health and substance abuse resources for the community they serve.
KEY TOPICS
• Roaya’s Journey: From a law-bound college student affected by family addiction to a clinical leader reshaping mental health in Florida.
• The Evolution of Mental Health: How treatments, diagnoses, and stigma have shifted over the past three decades.• Integrated Care: Why combining behavioral health and primary care under one roof is changing lives.
• Stigma Still Hurts: Breaking down mental illness myths and why physical and mental health must be treated equally.
• Provider Shortages: The real reasons we don’t have enough therapists—and why they’re paid less than they deserve.
• Safety Net Realities: What community mental health centers actually look like, and why they’re vital in every city.
• Crisis Response Tools: 988, mobile crisis teams, and why being prepared before a mental health emergency is crucial.• Youth & Social Media: The dark side of phones in schools, cyberbullying, and the growing mental toll on our kids.
• Tech & Telehealth: Where virtual therapy helps—and where it falls short.
WHAT'S NEXT?
This is just Part 1! In our upcoming episode, Chuck and Roaya return to explore Mental Health Parity—what it means, why it matters, and how new legislation could shift the entire healthcare system. Don’t miss it.
ADVOCACY IN ACTION
Visit DisruptiveDialogue.org to:
• 📝 Send a prewritten letter to your legislator
• 📚 Learn more about mental health policy
• 🧭 Find local and national resources
Don’t just listen—be part of the change.
How did one of the richest countries on earth end up with a healthcare system that impacts businesses as much as it hurts their employees? In this episode of Disruptive Dialogue, Chuck Melendi sits down with long-time friend and financial expert Scott Robey, a seasoned partner at Warren Averett, to tackle the economic cost of healthcare—beyond hospital visits and prescriptions.
Together, they break down how rising healthcare expenses ripple through industries, drive inflation, impact employments levels, and put U.S. companies at a global disadvantage. It’s a straight-up, no-fluff conversation—fueled by decades of experience and a splash of Woodford Reserve.
What You'll Hear:
· Why healthcare isn't just a personal issue—it's a business and economic problem
· How rising healthcare costs impact employment levels, inflation, and employer competitiveness
· Real-world financial and business insight from Scott’s 30+ years in public accounting
About our Guest:
J. Scott Robey is a Member in in Warren Averett’s Tax Division and has been practicing since 1988. He is a leader in the estate planning services with experience in all phases of audits, reviews, compilations, consulting and tax services. His industry experience includes construction firms, real estatedevelopers, engineering and architectural firms, wholesale distributors, insurance agencies, professional firms, physicians, real estate brokerage and management operations, automobile dealerships and farming operations.
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This is not your average healthcare talk. It’s Disruptive Dialogue— passionate, fact-driven, and unapologetically honest. Tune in every Monday for a new conversation. Remember to like, subscribe, share, and catch every conversation.
Get informed. Get involved. Let’s fix this — together.
Visit DisruptiveDialogue.org to access resources, podcast notes, subscribe to our newsletter, and connect with Chuck for speaking engagements or to share your story.
Follow Chuck at
Instagram: @disruptive.dialogue
Facebook: @disruptivedialoguepodcast
LinkedIn: @chuckmelendi
What happens when you’re insured, in pain, and still can’t get the help you need? In this episode, Chuck sits down with John Hoffman, an industry leader in health policy advocacy and a long-time veteran of the healthcare industry with an impressive 37-year tenure at Johnson & Johnson. Together, they unpack the frustrating, expensive, and often absurd realities of the American healthcare system.
See how good intentions morphed into financial incentives—and why even the best physicians are now bound by spreadsheets, not science. With a combined 75+ years of healthcare experience, Chuck and John break down the tangled mess of managed care, drug rebates, hospital consolidation, and the dangerous loopholes that reward the highest prices over the best care.
Take Action!
📣 Share this episode with someone fed up with healthcare gatekeepers
📬 Visit disruptivedialogue.org for tools to contact your legislators
🗳️ Demand transparency from PBMs, insurers, and hospital systems
📚 Read up on issues like non-medical switching and co-pay accumulators
🎧 Subscribe, rate, and review Disruptive Dialogue with Chuck Melendi
👉 Visit DisruptiveDialogue.org to access resources, podcast notes, and connect with Chuck for speaking engagements or to share your story.
💥 Don’t hate the player—hate the game. Then help rewrite the rules.
📱 Follow Us:
Instagram: @disruptive.dialogue
Facebook: @disruptivedialoguepodcast
LinkedIn: @chuckmelendi
What You’ll Learn in this Episode:
How PBMs and insurers make more from higher drug prices—not less.
How hospital consolidation drives costs up
Why independent doctors are vanishing—and younger physicians are opting out
The hidden power of vertical integration (and why it’s bad for patients)
How state-level advocacy sets the stage for national healthcare reform
How one phone call to your legislator can make a difference
Quotes of Note:
“Rebates are the crack of the healthcare system—every player is addicted.”
“Five major drug companies make less than one insurer—each. Let that sink in.”
“Physicians aren’t artists anymore—they’re cookbook followers stuck in a managed care kitchen.”
“If you're not part of the solution, you're part of the problem. Silence is no longer an option.”
Resources Mentioned
1. CSRO Advocacy Tools – Find your legislator and send a customizable letter
2. Kaiser Family Foundation – Patient-friendly policy explainers
3. Drug Channels Institute – Vertical integration trends in healthcare
4. White Paper by John Hoffman – Coming soon
5. Disruptive Dialogue Episode 2: Follow the Money
6. Dr. Maddie Feldman Interview. On Disruptive Dialogue – PBMs and drug rebates explained
Additional Resources That Inform This Episode:
• Inflation Reduction Act (2022)
• Stark Law limitations vs. insurer self-referral loopholes• “Profit-Based Medicine” – John Hoffman’s forthcoming book
• Drug Channels: 2025 Consolidation Trends
• “PBM Reform and the Help Copays Act” – Congressional updates (May 2025)
In this timely follow-up to last week's breakdown of the prescription drug pricing crisis, Chuck dives even deeper into the root causes—and policy battles—behind the price tags we all feel.
From patent games that block generics to the ripple effects of President Trump’s recent executive order, Chuck breaks down the complex ecosystem of drug pricing like only an insider can. If you thought the system was rigged before… just wait until you hear how long some patents last (spoiler: Humira had a 25-year run). This episode hits everything from global price benchmarks to why Florida can’t just import meds from Canada.
What You’ll Learn
How drug companies extend patents through “patent thickets” – keeping generics off the shelves
Why “list price” transparency in drug ads might be the next big push
The truth about importing cheaper drugs from other countries—and why it’s not that simple
How price controls differ from negotiations (and why it matters for Medicare patients)
Why insurers may block access to government-negotiated drugs (yes, they really can)
The unintended consequences of the Inflation Reduction Act—higher premiums and limited access
What happens when cutting-edge drugs come with 18-year post-approval monitoring costs
Why obesity drugs may require government subsidies to drive true healthcare savings
Quotes of Note
“Humira was approved in 2002. It didn’t go off patent until 2023. That’s not innovation—that’s strategy.”
“Three in ten Americans skipped doses or prescriptions last year due to cost. That led to 125,000 deaths and $300 billion in system waste.”
“We’re negotiating prices, but insurers are saying, ‘We’re not putting those drugs on the formulary—there’s no rebate in it for us.’”
“You can’t just say ‘Let’s import from Canada.’ Canada doesn’t have the supply—and drug makers won’t just sit back and take the hit.”
“Insurers, PBMs, and some hospitals—answer to shareholders, not patients. That’s the root of the problem.”
Resources Mentioned
1. President Donald J Trump’s 2025 Executive Order addressing Drug Pricing
2. “Unintended Consequences of IRA Drug Price Negotiations” by Mark Fendrick and Real Clear Health. October 7, 2024. A. Mark Fendrick, M.D.
3. ”Pioneer Institute Launches Tracker Showing Drug Price Controls Are Raising Out-of-Pocket Costs for Medicare Patients. American First Policy Institute
4. “Trump’s US Drug-Pricing Plan Would Cost the Rest of the World” by Naomi Kresge and Ashleigh Furlong
5. “Put Americans First by Ending Global Freeloading” by Charlie Katebi, March 21, 2025. Issue Brief from America First Policy Institute. This makes the case against what it calls pharmaceutical "global freeloading" and outlines various policy measures to address it.
6. F.D.A. Issues First Approval for Mass Drug Imports to States From Canada https://www.nytimes.com/2024/01/05/health/drug-imports-canada-florida.html - New York Times by Christine Jewett & Sheryl Gay Stolberg
7. The weight-loss drug revolution exposes the weakest links in our health care system - drug pricing and insurance. September 2024 article
Additional Resources that inform this episode:
Inflation Reduction Act (2022)
U.S. drug patent records for Humira and Enbrel
Taiwanese study on obesity drugs and mortality reduction
FDA regulations on post-market drug monitoring
Florida’s drug importation legislation and Canadian export restrictions
Take Action!
📣 Share this episode with someone who’s frustrated with high drug costs🗳️ Contact your legislators—demand guardrails on insurers and PBMs, not just manufacturers
💻 Visit disruptivedialogue.org for podcast resources & ways to get involved
🎧 Subscribe, rate, and review Disruptive Dialogue wherever you listen
💥 Don’t hate the player—hate the game. Demand transparency.
Welcome back, disruptors! In this two-part episode, Chuck digs into one of the most frustrating issues in healthcare: the skyrocketing cost of prescription drugs. After years of personally negotiating drug contracts with PBMs and insurers, he saw how the sauce was made – and now he is sharing that with you. From gag clauses in pharmacy contracts to middlemen pocketing billions, Chuck reveals how the system is designed for profits - not for patients.
This one’s personal, fiery, and packed with eye-opening insights (plus a shot of Fireball to kick things off). FOR EPISODE SLIDES, visit https://www.disruptivedialogue.org/get-involved.
Tune in next week for Part 2 and a look at the potential impacts of President Trump’s executive order on drug pricing.
What You'll Learn
Why drug prices in the U.S. are higher—even for generics—than in many other countries
The hidden role of Pharmacy Benefit Managers (PBMs) and how they control drug access and pricing
How insurance companies, hospitals, and wholesalers are inflating costs at every level
The truth behind “list prices” and why discounts often don’t reach the patient
How gag clauses used to keep pharmacists from telling you the cheaper option
Why generic drugs are cheaper to insurers—but not always to you
How the Inflation Reduction Act helps… and where it still falls short
Quotes of Note
🏥 “Seven healthcare companies made revenues of $1.7 trillion in 2023—and five were insurers.”
📉 “Net drug prices have gone down for seven years. So why are our costs still going up?”
🧾 “The same drug can cost $400 in one Michigan county and $3,300 in another—with the same insurer.”
💊 “My insurance premium is $1,000 a month, and it would’ve cost me more to use my insurance than pay cash.”
Sources Mentioned
Drug Channels Institute (Adam Fein)
Kaiser Family Foundation healthcare spending breakdown
2023 Wall Street Journal article: “Same Drug, 2,200 Prices”
Inflation Reduction Act (2022)
Florida legislation banning pharmacy gag clauses
Take Action!
📢 Share this episode with someone who’s fed up with high drug prices
📬 Contact your legislators—demand transparency from insurers, PBMs, drug manufacturers, and hospitals
🧠 Stay informed: visit disruptivedialogue.org for episode slides and more
💥 Don’t hate the player—hate the game.
🎧 Subscribe, rate, and share Disruptive Dialogue with Chuck Melendi wherever you get your podcasts.
Welcome back! In this week’s episode, Chuck sits down with independent pharmacist Dr. Scott Fritch for a powerful conversation about what’s really going on behind your pharmacy counter.Dr. Fritch reveals how major insurance companies and their pharmacy benefit managers (PBMs) have created a rigged system that squeezes out independent pharmacists, limits patient access, and confuses the public with the lack of transparency endemic in the system. He and Chuck expose how PBMs can manipulate drug pricing, mislead employers on their cost savings, and even launch smear campaigns against those who speak up.
If you’ve ever wondered why your prescription costs keep climbing, or why your trusted local pharmacist is closing shop, this episode is a must-listen.
What You’ll Hear:
-Why the pharmacy system is set up to benefit insurers, not patients and employers
-How PBMs use “spread pricing” and “rebate traps” to drive up costs
-What happens when pharmacists are forced to fill prescriptions at a loss
-The growing threat to independent pharmacies across the country
-The dangerous disconnect between prescribing doctors and medication coverage
-Why standing up — even when it’s risky — matters more than ever.
Memorable Quotes:
“We’re not trying to break the system — we’re trying to save it.” – Dr. Scott Fritch
“If you’re a pharmacist and you’re silent, you’re part of the problem.” – Chuck Melendi
“Support your independent pharmacist. Push back. Ask questions. You can make a difference.” – Dr. Scott Fritch
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💥 This is not your average healthcare talk. It’s Disruptive Dialogue with Chuck Melendi - the show that pulls back the curtain on America’s broken healthcare system. Your host, Chuck Melendi, spent 35 years in the industry — including 25 with Johnson & Johnson — and he’s seen enough to know: Americans are being ripped off.
Tune in every Monday for a new conversation.
🎙 Get informed. Get involved. Let’s fix this — together.
👉 Visit DisruptiveDialogue.org to access resources, podcast notes, and connect with Chuck for speaking engagements or to share your story.
📬 Subscribe to our newsletterhttps://www.disruptivedialogue.org/
📱 Follow Us
Instagram: @disruptive.dialogue
Facebook: @disruptivedialoguepodcast
LinkedIn: @chuckmelendi
Welcome back to Disruptive Dialogue with Chuck Melendi, the show that pulls back the curtain on America’s broken healthcare system and calls the community to action. Your host, Chuck Melendi, spent 35 years in the industry — including 25 with Johnson & Johnson — and he’s seen enough to know: Americans are being ripped off.
In This Episode:
Chuck is joined by Dr. Madelaine (Mattie) Feldman, a renowned rheumatologist and fierce advocate for patient access. With decades of experience treating chronic illness and fighting the gatekeepers of drug pricing, Dr. Feldman delivers a revealing perspective, from a practicing physician, of how pharmacy benefit managers (PBMs) have distorted our healthcare system for profit.
From misleading rebate schemes to patients being denied needed medications, this episode shines a light on the murky business of pharmaceutical pricing —and the urgent need for reform. Dr. Feldman also shares her experiences testifying before Congress and fighting on behalf of both doctors and patients.
What You'll Hear:
• What pharmacy benefit managers (PBMs) are — and how they secretly control drug prices
• Why patients get denied the medications prescribed by their doctors
• The “formulary exclusion” loophole hurting patients with chronic illness
• How rebate games enrich PBMs while leaving patients in pain
• Why most people — including doctors — don’t understand how bad the system really is
• Dr. Feldman’s advocacy work at the state and federal levels
• Eye-opening stories from the front lines of rheumatology and patient care
• What we need to change — and how you can help
About our guest:
Dr. Madelaine Feldman
• Managing Partner, The Rheumatology Group (New Orleans)
• Former President, Coalition of State Rheumatology Organizations (CSRO)
• National expert on PBMs, drug pricing, and healthcare policy reform
• Congressional and FTC Testifier | Patient Advocate
📚 Publications & Resources: Alliance for Transparent & Affordable Prescriptions (ATAP)
Memorable Quotes:
"PBMs are middlemen with no medical training who decide what drugs you can have — and make billions doing it." – Dr. Madelaine Feldman
"The rebate system is a legalized kickback. It’s hurting patientsand enriching gatekeepers." – Dr. Madelaine Feldman
"We need to understand who’s profiting — and who’s paying the price." – Chuck Melendi
💥 This is not your average healthcare talk. It’s Disruptive Dialogue— passionate, fact-driven, and unapologetically honest. Tune in every Monday for a new conversation.
🎙 Get informed. Get involved. Let’s fix this — together.
👉 Visit DisruptiveDialogue.org to access resources, podcast notes, and connect with Chuck for speaking engagements or to share your story.
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Welcome back to Disruptive Dialogue, the show that pulls back the curtain on America’s broken healthcare system. Your host, Chuck Melendi, spent 35 years in the industry — including 25 with Johnson & Johnson — and he’s seen enough to know: Americans are being ripped off.
In This Episode:
Chuck Melendi welcomes guest Jenn Munchel to share her inspiring story in Disruptive Dialogue’s powerful first interview. Jenn, a former social worker and teacher, opens up about her daughter Mila’s unexpected diagnosis with juvenile idiopathic arthritis at just two years old.
Together, Chuck and Jenn dive into the emotional journey of navigating a challenging healthcare system — from delayed diagnoses and insurance battles to finally finding life-changing treatment. Jenn’s advocacy work with the Arthritis Foundation highlights the importance of patient empowerment, community support, and the ongoing fight for better healthcare access.
Their conversation sheds light on the struggles families face, celebrates small victories, and offers hope to others walking a similar path.
What You'll Hear:
About our guest:
Memorable Quotes:
"If you're not telling your story, people don't even know that you need help." – Jenn Munchel
"Without Big Pharma, my kid can’t walk. How crazy is that to say?" – Jenn Munchel
"Don't complain. Do something about it." – Chuck Melendi
💥 This is not your average healthcare talk. It’s Disruptive Dialogue — passionate, fact-driven, and unapologetically honest. Tune in every Monday for a new conversation.
🎙 Get informed. Get involved. Let’s fix this — together.
👉 Visit DisruptiveDialogue.org and join the movement. Here you find resources and podcast notes, and connect with Chuck directly for speaking engagements and to share your story.
_____________________________________________________
Subscribe for our upcoming newsletters! Visit https://www.disruptivedialogue.org/
Looking for our socials?
Instagram: @disruptive.dialogue
Facebook: @disruptivedialoguepodcast
LinkedIn: @chuckmelendi
Welcome back to Disruptive Dialogue, the show that pulls back the curtain on America’s broken healthcare system. Your host, Chuck Melendi, spent 35 years in the industry — including 25 with Johnson & Johnson — and he’s seen enough to know: Americans are being ripped off.
In This Episode:
Chuck pulls back the curtain on one of the biggest drivers of the U.S. healthcare crisis: corporate profit. While Americans struggle to afford care, a small group of healthcare giants are raking in trillions. In this explosive episode, we break down:
Why Everything Costs More in U.S. Healthcare
From drugs and insurance to hospital stays and devices—every single aspect of the system costs more in the U.S. than anywhere else.
Who’s Cashing In?
Chuck spotlights the biggest players across healthcare sectors and their explosive revenue growth from 2010 to 2023:
• Insurers like UnitedHealth, CVS/Aetna, and Cigna have ballooned to dominate the market—together, the top five raked in revenues of $1.25 trillion in 2023.
• Drug Wholesalers like McKesson and AmerisourceBergen (now Cencora) earned a combined $742 billion.
• Compared to Big Pharma: While the five largest drug manufacturers earned a whopping $311 billion in revenues, that's still less than one single top insurer.
• Hospitals may claim “non-profit” status, but the top five took in $260 billion, with questionable transparency and ballooning executive pay.
The Real Power Players:
Just eight companies made over $2 trillion in revenues in 2023. And they’re not just in healthcare—they are the healthcare system now. They control access, pricing, and profits—and they’re more focused on Wall Street than patient care.
Critical Insights:
• Why middlemen like insurers and PBMs (Pharmacy Benefit Managers) are making care harder to access and more expensive.
• The system is confusing by design—and it’s leaving patients, doctors, and small businesses in the dust.
• Countries with better outcomes and lower costs don’t have these bloated middle layers. So why do we?
The Fallout:
• Physician burnout
• Collapsing independent pharmacies
• Rising costs for employers
• Patients avoiding care or drowning in debt
Why Create Change?
This isn’t about politics—it’s about survival. The cost to employers drives up cost of goods sold, the cost to consumers drives medical debt, and providers are burning out. If we don’t address the greed at the heart of the system, our health, economy, and future are all on the line.
💥 This is not your average healthcare talk. It’s Disruptive Dialogue — passionate, fact-driven, and unapologetically honest.
🎙 Get informed. Get involved. Let’s fix this — together.
👉 Visit DisruptiveDialogue.org and join the movement. Here you find resources and podcast notes and connect with Chuck directly for speaking engagements and to share your story.
Remember to subscribe, comment, review, and share this podcast!
_____________________________________________________
Want the slides from today’s episode? Visit https://www.disruptivedialogue.org/get-involved
Subscribe for our upcoming newsletters! Visit https://www.disruptivedialogue.org/
Looking for our socials?
Instagram: @disruptive.dialogue
Facebook: @disruptivedialoguepodcast
LinkedIn: @chuckmelendi
Welcome to the introductory episode of Disruptive Dialogue, the show that pulls back the curtain on America’s broken healthcare system. Your host, Chuck Melendi, spent 35 years in the industry — including 25 with Johnson & Johnson — and he’s seen enough to know: Americans are being ripped off.
Here’s the harsh reality:
• The U.S. ranks dead last in healthcare performance among 10 developed nations.
• In 2023, we spent nearly $5 trillion on healthcare — that’s over $14,500 per person.
• Rising healthcare costs are crushing our economy, becoming the second-largest expense for U.S. employers after wages — shrinking worker paychecks and making American businesses less competitive.
So where’s all that money going?
Chuck follows the money trail — and it leads straight to the middlemen: insurers, pharmacy benefit managers (PBMs), and drug wholesalers. Just eight Wall Street-driven companies now control over $2 trillion annually in our healthcare system. They were never supposed to have this much power, and Chuck is here to explain how they got it — and what it’s costing us.
This podcast doesn’t just diagnose the problem — it’s a call to action. Chuck shares:
• Insights from industry whistleblowers and healthcare insiders
• Providers and patients impacted by the system
• Resources to contact your lawmakers and fight for change
• A growing community where you can share your story and get involved
Chuck utilizes trusted sources like the Wall Street Journal, Kaiser Family Foundation, Avalere, and industry experts like Wendell Potter, Adam Fein, Antonio Ciaccia, and more.
💥 This is not your average healthcare talk. It’s Disruptive Dialogue — passionate, fact-driven, and unapologetically honest.
🎙 Get informed. Get involved. Let’s fix this — together.
👉 Visit DisruptiveDialogue.org and join the movement. Here you find resources and podcast notes and connect with Chuck directly for speaking engagements and to share your story.
Remember to subscribe, comment, review, and share this podcast!
_____________________________________________________
Want the slides from today’s episode? Visit https://www.disruptivedialogue.org/get-involved
Subscribe for our upcoming newsletters! Visit https://www.disruptivedialogue.org/
Looking for our socials?
Instagram: @disruptive.dialogue
Facebook: @disruptivedialoguepodcast
LinkedIn: @chuckmelendi
