Bertolini: Conflicting economic models make US healthcare structurally dysfunctional
Mark Bertolini · The CEO Who Cheated Death, Slept an Hour a Night, and Built a Healthcare Empire · Invest Like The Best · Aug 19, 2025 · at 32:58
Mark Bertolini, CEO of Oscar Health and former CEO of Aetna, outlines the structural incentives misaligning US healthcare actors.
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“Physicians, 760,000 or so, all work on a cash basis. That's their accounting model. The hospital systems and the facilities that provide healthcare around the country work on a revenue basis. As long as I have enough revenue coming in, I can win. And then you have insurance companies and pharmaceutical companies and biomedical research companies and DME and all these other companies that work on a margin basis. And so you have 760,000 physicians cash basis. You have 6900 hospitals and add probably another 6900 facilities as well, so almost 13,000 that work on a revenue basis. Then you've got an act 1300 insurance companies and add up all the others that are on a margin basis, and you put those economic models together, it's a wonder people get care at all.”
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