Disruptive Dialogue with Chuck Melendi

The healthcare system in our country is broken. It is time to fight for change, and to do it together. Tune in as retired industry executive Chuck Melendi and Disruptive Dialogue explore how healthcare corporations are sticking it to patients, providers and businesses. You need to know what is really going on in our overpriced and underperforming healthcare system. Consumers and their employers pay too much money for too little care, and the players running the show are making billions.Let’s create solutions, and let’s demand results. LET'S FIX HEALTHCARE.

Disruptive Dialogue with Chuck Melendi is a health podcast hosted by Chuck Melendi, with 39 episodes on record and a Required Pod Score of 80.

Chuck Melendi hosts Disruptive Dialogue with Chuck Melendi, a health show with 39 episodes published.

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  Episode #21

  340B, Hospital Consolidation, and Where the Money Goes | ft. Brian Reid

  Sep 15, 202634 minS3

  Hospitals drive close to a third of all healthcare spending in this country, and today we turn the focus there. My guest is Brian Reid, author of the daily Cost Curve newsletter and a former Bloomberg and Washington Post health policy reporter. We dig into 340B, a drug discount program written as a two-page law in 1992 that now moves more than $100 billion a year, and Brian lays out who really collects the discount and what employers are losing in the process. Then we get into what happens to prices when hospitals buy up independent physician practices, and why he says the best thing you can do is be skeptical of size. Call the Capitol switchboard at 202-224-3121 and tell your members that hospital pricing and 340B are on your ballot. Links: reidstrategic.com/cost-curve · costcurve.beehiiv.com Chapters: -Meet Brian Reid and the Cost Curve newsletter -Why the focus turns to hospitals this year -340B in plain English, and the small problem it was written to solve -How a safety-net program grew past $100 billion -Who actually gets the discounted drug -Charity care, nonprofit status, and the missing evidence -Employers eat the duplicate discount -Contract pharmacies and the PBM cut -Why the same scan costs more once a hospital owns your doctor -Be skeptical of size Remember to subscribe to see what's next! And together, #LetsFixHealthcare

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  Episode #20

  Insurers Profit From Denying Care. A Survivor Fights Back

  Aug 31, 202642 minS3

  Matt Zachary — brain cancer survivor at 21, founder of Stupid Cancer, and author of We the Patients — joins me to make the case that American healthcare isn't broken, it's finished. It was designed to move money, and denying your care is now more profitable than delivering it. We cover how employer-based coverage and the 1973 HMO Act got us here, the billions insurers make by saying no on purpose, why Medicare Advantage is neither, and what AARP gets paid to lend its name to a UnitedHealth product. Matt's answer isn't another awareness campaign. It's organizing patients into a bipartisan single-issue voter bloc big enough that state legislators have to hear us. We need “seatbelts” for patients, written into consumer protection law, and that means no denials, no delays for reasonable care, doctors decide, nobody goes bankrupt. That only works if you're counted. Take the five-minute anonymous national poll at wethepatients.org, and call the congressional switchboard at 202-224-3121 to tell your representative that healthcare costs decide your vote. A hundred calls is a five-alarm fire in a state office. LIKE this episode and SUBSCRIBE to keep it going! Links: www.disruptivedialogue.org www.wethepatients.org www.wethepatientsbook.com (buy indie) ·www.matthewzachary.com www.siubfilm.com Chapter list -Meet Matt Zachary — 25 years of work, and the book that finally got himtaken seriously -Not broken, built this way — employer coverage, the HMO Act, and theshift from service to product -"What insurance do you have?" — the question that decides who lives -The denial economy — how saying no on purpose became a profit center -Medicare Advantage is neither Medicare nor an advantage -The AARP card that isn't AARP — licensing a trusted name to seniors -Rig it in your favor — what patients are forced to learn mid-diagnosis -"Seatbelts" for cancer patients — borrowing Ralph Nader's playbook -Why doctors can't fight back — moral injury, and the ban on organizing -Building the voter bloc — why 10,000 people can speak for 20 million -Go to the states — PBM reform, protection bills, and where they die -How good laws get defanged — toothless fines and three-year delays -Suck It Up, Buttercup (film)— burnout, private equity, and rural America -Lightning round — the worst actors, and who's getting hurt most -Your call to action — take the poll, call the switchboard, keep calling

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  Episode #19

  The RX Podfather on PBMs, Pharmacy Burnout, and the Fight to Save Your Pharmacist | ft. Todd Eury, founder of the Pharmacy Podcast Network

  Jul 15, 202637 minS3

  Your pharmacist may be the last line of defense between you and a dangerous medication mistake — and the system is grinding them into the ground. This week, Chuck talks with Todd Eury, founder of the Pharmacy Podcast Network and the original voice of pharmacy podcasting since 2009, about the forces hollowing out one of healthcare's most trusted professions. With 17 years and more than 4,000 episodes behind him, Todd has watched PBMs evolve from a genuinely useful flat-fee service into multi-trillion-dollar middlemen that control which pharmacy you use, what you pay at the counter, and whether your neighborhood independent survives at all. He and Chuck get into the rebate shell game, the burnout crisis behind the pharmacy counter, and the landmark RICO lawsuit that could finally crack the whole thing open. What You'll Learn How PBMs started as a fair, flat-fee service and became some of the most powerful and least understood corporations in American healthcare. Todd's two fixes for the system: banning insurers from owning pharmacies, and flat-rate pricing for anything funded by taxpayer dollars. What the RICO class action against Express Scripts alleges, and why Chuck calls it a real tipping point. How the rebate shell game works — and why employers getting "100% of rebates" are often getting 100% of a fraction. Why Arkansas and Tennessee banned PBMs from owning pharmacies, and why senators from both parties want to break up the vertical integration. Todd's new "evidence-based podcasting" standard: peer reviewed medical audio you can actually trust, Take Action 📞 Call Congress directly at 202-224-3121 and tell your senators and representatives that healthcare needs the Ma Bell treatment — break up the vertical integration and restore real competition. 🌐 Learn more about the Pharmacy Podcast Network at PharmacyPodcast.com Disruptive Dialogue with Chuck Melendi — because the healthcare system isn't going to fix itself. Subscribe, share, and leave a review wherever you listen.

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  Episode #18

  The ALICE Crisis (pt 2): How America Can Stop Failing Its Working Families

  Jun 29, 202631 minS3

  In Part 1 of this series, Doug Griesenauer and I laid out the problem: 42% of American households are financially struggling right now, not because they aren't working, but because the federal poverty level — a formula built on 1955 grocery data — still determines who qualifies for help in 2026. Now in Part 2, we get into what we actually do about it. Doug returns to walk through the things that change practically and politically if policymakers adopt the ALICE threshold instead of the federal poverty level, and the difference is significant. Benefits phase out as families can genuinely afford to lose them instead of at an arbitrary cliff that punishes people for earning more. Financial stress drops. Workplace productivity rises. The math starts working for working families instead of against them. We also go somewhere many policy conversations won't: a hard look at whether large corporations are deliberately relying on public assistance programs to offset wages they should be paying themselves. Doug lays out a clear framework: micro solutions at the business level, meso solutions at the community level, and macro solutions at the policy level. And he makes thecase that this is NOT a partisan issue, because when you strip away the labels, most Americans across the political spectrum agree that people who work hard should be able to get by. Key topics covered: -What immediately improves for working families if ALICE replaces the federal poverty level -Why financial stability helps workers but also makes businesses more productive and the broader economy stronger -The uncomfortable question of whether corporations are subsidizing low wages with public benefits -Matthew Desmond's research on the true cost of addressing poverty — and why it's a matter of will, not budget -The two-path solution every American needs to understand: raise wages or update the support threshold OR both! -Practical steps anyone can take, including the Volunteer Income Tax Assistance Program This two-part series is essential listening for anyone who wants to understand why the American safety net fails working families, and what a better system looks like. Guest: Doug Griesenauer, VP of Community Impact, United Way Suncoast ALICE Research: unitedforalice.org Recommended reading: Poverty by America by Matthew Desmond Take action: Call 202-224-3121 to reach your congressional representatives and tell them that healthcare costs and reform to the outdated federal poverty level are priorities If this series opened your eyes, please subscribe, share it with someone who needs to hear it, and leave us a review. Until next time — stay informed and take charge of your health. Disruptive Dialogue is hosted by Chuck Melendi, a 35-year healthcare industry veteran committed to exposing the systems failing American patients.and the people working to change them. New episodes every two weeks.

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  Episode #17

  The ALICE Crisis: Why 42% of Working Americans Struggle to Make Ends Meet

  Jun 19, 202633 minS3

  Did you know that the federal poverty level was built on grocery price data from 1955 — and has never been updated to reflect how we live in America today? In this episode, Chuck sits down with Doug Griesenauer, VP of Community Impact at United Way Suncoast in central Florida, to unpack one of the most overlooked crises in our country: the gap between who our safety net programs offer to help and who actually needs it. They dig into ALICE — "Asset Limited, Income Constrained, Employed" — a research framework that reveals 55 million American households are financially struggling right now. Not because they're not working. Because the system wasn't built for how we actually live. What you'll learn in this episode: Why the federal poverty level is broken in three distinct ways — and why policymakers have known it since the 1960s What ALICE is and why it's a far more accurate picture of financial hardship in America The "fiscal cliff" (also known as the "valley of death") — why getting a raise or a promotion can actually leave working families worse off How financial instability drives people straight into the most expensive healthcare settings: emergency rooms Why 42% of America is struggling financially — and most of us never see it This isn't a conversation about handouts. It's about hardworking people — single parents, dual-income families, people working two jobs — who are doing everything right and still can't afford housing, childcare, transportation, or healthcare. That's a policy failure, not a personal one. This is Part 1 of a two-part series. Part 2 drops next week. Subscribe so you don't miss Part 2 Like if this opened your eyes Did any of these numbers surprise you? Take action: Call 202-224-3121 to reach your senators and representatives. Tell them healthcare costs and the outdated federal poverty level need to be addressed — now. CHAPTERS 00:00 Introduction — The quiet gap in America 01:50 Meet Doug Griesenauer, United Way Suncoast 03:20 Financial health IS physical health — the dental divide 04:50 What is the federal poverty level and where did it come from? 05:15 Dr. Molly Orshansky and the 1955 grocery basket 08:30 Three ways the FPL is broken: food, geography, and household type 15:00 What ALICE is and how it was built 19:10 The ALICE numbers: what it actually costs to get by by state 21:35 42% of America — 55 million households — are struggling 22:30 Why wages haven't kept up and costs keep climbing 26:30 The fiscal cliff: why a raise can make you poorer 28:10 Refusing promotions might be the smart economic choice — and that's a system failure 30:32 Chuck's call to action CONNECT & LEARN MORE 🌐 Disruptive Dialogue: www.disruptivedialogue.org 📊 ALICE Research: unitedforalice.org Disruptive Dialogue is hosted by Chuck Melendi, a 35-year healthcare industry veteran on a mission to expose the systems failing American patients — and the people trying to fix them.

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