The 80-year-old mistake at the heart of US healthcare | Mark Bertolini, Oscar Health

Mark Bertolini, CEO of Oscar Health, has run healthcare from every seat: CEO of Aetna, co-CEO of Bridgewater, and now head of the insurer he calls a pirate ship among Spanish galleons. He and Chrissy trace how an 80-year-old wartime workaround became the employer-sponsored system nobody is incentivized to fix, and what replaces it: one risk pool, a portable bucket of your own money, and a plan you keep for life. Along the way: the ICHRA mechanism, the $32 shower chair, the system priced at $468, and the personal story behind his hospice reform at Aetna.

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SPONSOR:
Oscar Health, Inc. is on a mission to give people greater power over their healthcare by building a more consumer-driven healthcare system. By leveraging technology to place individuals at the center of their healthcare experience, Oscar is transforming the industry into one that is proactive, personal, and transparent. Through its insurance subsidiary, Oscar Insurance, the company provides individual market health plans, innovative digital tools, and support for models such as ICHRA, helping people make more informed decisions with greater choice and coverage tailored to their needs.

Dive into our conversation on Oscar's blog: https://www.hioscar.com/blog/future-of-healthcare-conversation-mark-bertolini?utm_source=lifers_youtube-organic&utm_campaign=all_null_christina-farr-mark-bertolini&utm_medium=national_all_null&utm_term=future-of-healthcare-blog 

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LINKS:
Oscar Health: https://www.hioscar.com/ 
Lucie Health Marketplace: https://www.luciehealth.com/ 

Chrissy Farr on YouTube: https://www.youtube.com/@LiferswithChristinaFarr 
Chrissy Farr on Instagram: https://www.instagram.com/cfarr/ 
Subscribe to the Second Opinion Newsletter: https://secondopinion.media/ 
Chrissy’s Book: The Storyteller's Advantage: https://www.chrissyfarr.com/books 

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FOLLOW:
Mark:
https://www.linkedin.com/in/markbertolini 

Chrissy:
https://www.linkedin.com/in/christinafarr/ 
https://x.com/chrissyfarr 

Second Opinion Media:
https://www.instagram.com/second.opinion.media/ 
https://x.com/second_op_media 
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TIMESTAMPS:
(00:00) Preview
(00:25) Why employer loyalty doesn't exist anymore
(02:12) How World War II built the system we have
(03:02) Three economic models pushed together
(04:47) The $23,000 question at CNBC
(06:23) Conflating financing and investment
(08:18) The three employer-sponsored insurance markets
(09:57) Pooling every American and giving them their own bucket
(11:09) The churn problem and lifetime value
(14:32) Squaring the morbidity curve
(16:48) What ICHRA is and why Oscar is betting on it
(18:45) Curated pricing, the Lucie Health marketplace
(21:53) What the system refuses to curate
(23:23) Rewriting the hospice program
(26:22) Dignitas and how we talk about dying
(28:25) Why CEOs haven't dropped healthcare yet
(31:03) Machiavelli and the tenure problem
(32:43) Which employers tip first
(34:14) Growing up in Detroit
(34:51) Never count anyone else's money
(37:22) From the Ford assembly line to accounting
(39:05) Why spreadsheets give the illusion of certainty
(40:45) Choosing Oscar
(43:38) Reasons to believe
(46:14) Wrap