Defund Systemic Healthcare Waste: Making Wiser Healthcare Investments

What if protecting your health also means becoming much more intentional about **where your healthcare dollars go?** In this episode of *The Architecture of Health*, I talk with **Kevin Decker, RN**, who brings 25 years of nursing experience across emergency care, ICU, med-surg, bedside nursing and managed care. He has seen the American healthcare system from both the patient-care side and the insurance side. Our conversation follows the money. Why does the United States spend so much on healthcare while so many families still face enormous premiums, deductibles, denied claims and medical debt? How much of what we spend actually supports better health—and how much feeds administrative complexity, distorted incentives and systemic waste? We explore: • Why healthcare administrative costs have become so enormous • Insurance denials—and why appealing a denial can matter • PBMs, pharmacy pricing and vertical integration • Why paying cash can sometimes cost less than using insurance • How physician-training policies contributed to today’s doctor shortage • The Medicare residency cap created by the 1997 Balanced Budget Act • Rising family health-insurance costs • Health-sharing programs: potential advantages and important limitations • The difference between investing in health and simply consuming more healthcare • Why avoiding the medical system entirely can also be dangerous • Prevention, personal responsibility and healthcare sovereignty • How to preserve more of your resources for the things that actually support your health This is **not an argument against medicine**. Emergency medicine, surgery and other medical interventions can be extraordinary and lifesaving when they are truly needed. I share my own experience of delaying treatment because of cost until an infection became dangerously serious. The question is not: **“How do we stop spending money on healthcare?”** It is: **“How do we make wiser healthcare investments—and stop automatically funding what isn’t working?”** Kevin Decker has spent approximately 25 years in nursing, with experience in emergency medicine, ICU, med-surg, bedside care and managed care. His experience on both the clinical and insurance sides of healthcare informs his work helping individuals and businesses examine healthcare spending and make more intentional financial decisions. **Website:** www.Builtnotgivenrn.com/home **Instagram:** @deckeressentialservices **Facebook:** Decker Essential Services **Email:** [kevin@builtnotgivenrn.com](mailto:kevin@builtnotgivenrn.com) **Deb Voisin** is the host of *The Architecture of Health* and founder of **Moving As Designed**. After more than 25 years working in design research and user experience, Deb became increasingly interested in another kind of design problem: **What actually creates a human being who remains capable, adaptable and physically independent over a lifetime?** Her work explores movement longevity, prevention, human-centered health, environmental design and the systems that shape our bodies and behavior. Through *The Architecture of Health*, Deb talks with researchers, clinicians, movement experts, independent thinkers and innovators about how we can build healthier lives before crisis becomes the only option. **Moving As Designed:** moveasdesigned.com Healthcare-sharing programs are discussed in this episode as one option some people use to reduce traditional insurance costs. **Health shares are not health insurance.** They do not necessarily carry the same consumer protections as regulated insurance, and payment of eligible medical expenses is not guaranteed in the same way an insurance contract is. Anyone considering one should carefully investigate exclusions, limits, eligibility requirements, pre-existing-condition rules and the organization’s financial history. **This podcast is for education and discussion only and is not individual medical, legal, insurance or financial advice. Statements of opinion or interpretation made during the conversation should be distinguished from the research and data referenced above.**