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Guest: Josh Umbehr, MD | Co-founder & CEO, Atlas MD | DPC Pioneer
Summary: In 2010, Josh Umbehr launched Atlas MD charging $50/month for unlimited primary care with no insurance billing. Other doctors said it wasn't sustainable. Fourteen years later, he runs a platform serving 1,800+ practices and built his own insurance company. This conversation covers the full journey: wholesale medication costs ($0.01/pill metformin), the $2M it takes to start insurance, why Singapore's model works, and why 80% of healthcare spending is eliminable.
Key Topics:
- DPC Economics: How $50/month works ($2 CBC tests, cutting 5-6 staff)
- Building Insurance: $2M startup, actuarial challenges, association model
- Singapore Healthcare: What economists miss about primary care
- Fractional Specialists: 1,800 practices sharing one cardiologist
- CMS Meeting: "We can't participate and innovate"
- GLP-1 Pricing: Why insurance coverage raises costs
- Vaccine Nuance: Risk/benefit in context
- The 80% Solution: Eliminating waste, not rationing
Top Quotes:
- "80% of $4-5 trillion could be cut out. That's reasonable math, not wishful thinking."
- "We can't participate and innovate" [to CMS Administrator]
- "Best way to make GLP-1s affordable: stop covering with insurance"
- "Biggest DPC problem isn't the model—it's getting people to understand high quality + affordable price"
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